The risk of thyroid diseases in lichen sclerosus patients: a systematic review and meta-analysis

Abstract

Background/objective: Lichen sclerosus (LS) is a chronic inflammatory skin disease affecting both genital and extra-genital areas and is found predominantly in female patients. The relationship between LS and thyroid diseases remains unclear, with conflicting evidence reported in the literature. This systematic review and meta-analysis aimed to investigate the association between LS and thyroid diseases rigorously. Materials and methods: We conducted a comprehensive search using two electronic databases, MEDLINE and Embase, from inception to May 2024, to identify observational studies investigating the relationship between LS and thyroid diseases. A random-effects model was used to meta-analyse the pooled odds ratio with a 95% confidence interval (CI) from the included articles. Results: A total of 14 observational articles encompassing 22,112,979 participants were included. Nine of these studies included only female participants. The analysis revealed that LS was significantly associated with an increased risk of autoimmune thyroid diseases, with an odds ratio of 2.38 (95% CI, 1.46–3.86; I² = 84%). Additionally, an association was found between hyperthyroidism and an odds ratio of 2.01 (95% CI, 1.40–2.88; I² = 0%). Furthermore, patients with LS exhibited a non-significant increase in the odds ratio for Graves’ disease, Hashimoto’s thyroiditis, hypothyroidism and other unspecified thyroid disorders. Conclusions: This meta-analysis provided insight into thyroid diseases in patients with LS, revealing a significant association with an increased risk of autoimmune thyroid disease and hyperthyroidism. Further research is needed to clarify this association and enhance the comprehensive care of patients with LS.